Universität zu Köln

Meertens, Max M., Macherey, Sascha, Asselberghs, Sebastiaan, Lee, Samuel ORCID: 0000-0001-6768-7079, Schipper, Jan Hendrik, Mees, Barend, Eitel, Ingo, Baldus, Stephan, Frerker, Christian and Schmidt, Tobias (2022). A systematic review and meta-analysis of the cerebrovascular event incidence after transcatheter aortic valve implantation. Clin. Res. Cardiol., 111 (8). S. 843 - 859. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Objective Periinterventional stroke is one of the most feared potential complication, among patients treated with transcatheter aortic valve implantation (TAVI). The purpose of this review was to investigate the incidence of cerebrovascular events and the influence of postinterventional neurologic check-up in patients undergoing TAVI. Methods A systematic review and meta-analysis were conducted according to the PRISMA guideline. Three separate electronic searches of the public domains Medline and Clinicaltrials.gov were performed to identify the 30-day incidence of stroke within randomized controlled trials (RCTs) and registries for patients undergoing a TAVI procedure. A meta-analysis was conducted to evaluate the 30-day incidence of stroke within RCTs. Furthermore, we pooled the RCTs in which a scheduled neurological check-up was conducted or not to investigate the effect of this intervention. Results Twenty-three studies including 399,532,491 TAVI patients were included, 6370 from RCTs, 857,833 from cerebral-embolic protection device RCTs and 392,288 were adopted from registries. The mean 30-day incidence of stroke among all reviewed studies was 2.33%. In RCTs evaluating TAVI the pooled stroke incidence was 3.86%, among RCTs focused CEP the incidence was 6.4436% and in registries the incidence was 2.29%. Ten RCTs conducted scheduled neurological check-ups, the incidence in these was 4.03% and among the remaining RCTs it was 2.47%. In the meta-analysis, the pooled 30-day stroke incidence was 3.61% (95% CI 2.57-4.79%). Conclusion This systematic review demonstrates that the stroke incidences following TAVI differ strongly according to the study design and neurological follow-up. Intense neurological testing increases the incidence of a stroke after TAVI. [GRAPHICS] .

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Meertens, Max M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Macherey, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Asselberghs, Sebastiaan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Samuel UNSPECIFIED orcid.org/0000-0001-6768-7079 UNSPECIFIED Schipper, Jan Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Mees, Barend UNSPECIFIED UNSPECIFIED UNSPECIFIED Eitel, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerker, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-680099
DOI:	10.1007/s00392-022-01997-1
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	111
Number:	8
Page Range:	S. 843 - 859
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CEREBRAL EMBOLIC PROTECTION; RANDOMIZED EVALUATION; RISK PATIENTS; REPLACEMENT; STROKE; COMPLICATIONS; STENOSIS; INSIGHTS; OUTCOMES; QUALITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68009